1994 Volume 36 Issue 8 Pages 1553-1560
Pre-operative diagnosis of the depth of invasion and lymph node metastasis is impor-tant to decide the treatment of early gastric cancer. Endoscopic ultrasonography (EUS) was used to assess the indication for Dl-gastrectomy (gastrectomy with Nl lymph node dissection). Between April 1984 and September 1993, 596 cases with early gastric cancer, who underwent surgery, were evaluated clinico-pathologically. In 268 of 596 patients, EUS was performed pre-operatively. The ultrasonographic findings were compared with his-tological findings. The incidence of lymph node metastasis in mucosal cancer was significantly lower than that in submucosal cancer, and that in differentiated type was significantly lower than that in undifferentiated type. No lymph node metastasis were seen in mucosal cancer without ulceration within the tumor focus. In mucosal cancer with ulceration, the incidence of lymph node metastasis in cases with U1-II ulceration was lower than that in cases with U1-III, and IV ulceration. In 130 cases of types I, II-l, and II-2 in EUS pattern, 110 cases (84.6%) were mucosal cancer, and 101 cases (77.7%) were accurately diagnosed the depth of ulceration within the tumor focus. There was only one case of lymph node metastasis of Group 1 lymph node (nl) in this 130 cases. In conclusion, the indication for Dl-gas-trectomy seemed appropriate in cases with types I, II-1, and II-2 in EUS patterns.
